Flashcards in Exam #2: Head & Neck Examination Deck (51)
What are the seven attributes of a symptom?
5) Setting (in which it occurs)
6) Mitigating & Exacerbating Factors
7) Associated Symptoms
What is a primary headache?
A headache that is idiopathic — occurring for no obvious reason, and not the result of any underlying disease or process
What is a secondary headache?
A headache that arises from an underlying structural, systemic, or infectious cause
What are the different types of primary headaches?
4) Medication Rebound
5) Chronic Daily Headache
What are three potential causes of a secondary headache?
2) Subarachnoid Hemorrhage
3) Mass Lesion
Characteristics of a Migraine
-Throbbing or aching
-Peaks within 1-2 hours but can last 4-72 hours
-More common in women
-Associated Symptoms include nausea & vomiting
-Triggered by missing meals, menses, birth control, stress, food
Characteristics of a Tension Headache
-Bilateral or Unilateral
-Band-like, constricting & non-throbbing
-Gradual onset & lasts hours to days
-Photophobia & Phonophobia maybe, but NO nausea
-Triggered by stress, anger, and teeth grinding
Characteristics of a Cluster Headache
-Unilateral & retro-orbital
-Intense burning, searing, knife-like
-Abrupt onset that peaks in minutes
-Lasts several nights for several days and then gone
-More common in men
-Associated symptoms: increased tearing & nasal discharge
Characteristics of a Medication Rebound Headache
-Dull or Throbbing
-Onset hours or days after last dose & lasts hours
-Seen in patients taking daily analgesics w/ abrupt cessation
Red Flag Symptoms with Headaches
-Progressively frequent or severe
-Sudden onset- "Thunderclap"
-"Worst headache of my life"
-New onset after 50 years old
-Aggravated or relieved by a change in position
-Precipitated by the Valsalva maneuver
-Associated with fever, night sweats, or weight loss
-Hx of cancer, HIV infection, or pregnancy
-Associated papilledema, neck stiffness, or focal deficit
What should you consider if headache is severe and of sudden onset?
SAH or Meningitis
What is concerning of a headache that is new, persisting, & progressively severe?
Raises concern for tumor, abscess, or mass lesion
What types of headaches are unilateral?
Migraine & Cluster
What type of headache often arises in the temporal area?
What type of headache is often retro-orbital?
What type of headache has a prodrome?
Why is exacerbation of a headache with the Valsalva maneuver concerning?
May increase pain from acute sinusitis or mass lesion & ICP
What are important considerations in head trauma?
-Mechanism of Injury
-Level of Consciousness
-Time of Injury
-Bleeding from ears, nose, mouth, eyes
Disturbance in brain function caused by a direct or indirect force to the head, resulting in a constellation of symptoms that does not necessitate LOC
Symptoms suspicious for concussion
-Impaired brain function or confusion
What is the Sport Concussion Assessment Tool (SCAT2)?
Pre-season cognitive screening to be compared to post-injury; if athlete is not back to baseline, no participation
Symptoms of Hyperthyroid
-Excessive sweating/ heat intolerance
-Warm, smooth, moist skin
Symptoms of Hypothyroid
-Modest weight gain
-Dry coarse skin
-Swelling of face, hands, and legs
Conductive Hearing Loss
Problems with the external or middle ear
Sensorineural Hearing Loss
Problems with the inner ear, cochlear nerve, or its connections to the brain
Difficulty understanding speech & worse hearing in noisy enviornment
Noisy environment improves hearing
Medications that affect hearing
Perception of spinning caused by problems in the labyrinths of the inner ear, peripheral lesion of CN VIII, or central lesions of CN VIII